The War on Drugs Reexamined

How Marijuana Could Help Fight the Overdose Epidemic

Marijuana law enforcement should be left to the states to save lives

Editors Note: This is part three in a five-part series on a new approach to the War on Drugs. This is a nuanced topic and we present the views here as a contribution to the conversation. You can read Part I here and Part II here.

Seven states, which now include nearly 25 percent of the U.S. population, have voted to legalize the recreational use of marijuana — and 29 states allow at least some medical use. To old school anti-drug crusaders, these facts are horrifying, but if President Trump really wants to fight addiction, overdose and drug related harm, he’s going to have to let go of America’s misguided obsession with cannabis law enforcement.

Marijuana could actually help fight the overdose epidemic — but those effects will be diminished if the federal government starts interfering with the states that have legalized, either medically or recreationally. If Jeff Sessions is approved as attorney general — and if he continues to maintain his hardline stance against changing marijuana laws — President Trump should stick to his campaign promise to let the states decide and rein him in. Prosecuting marijuana offenses in states that have legalized will make fighting overdose deaths and opioid addiction much harder.

None of the catastrophes predicted by drug warriors have ever come to pass in any of the states or countries that have decriminalized or fully legalized marijuana. The longest running data comes from the Netherlands, which, since the 1970s, has allowed “coffee shops” to retail marijuana for personal use. The Dutch have long had lower rates of teen drug use than we do; they have a smaller problem with heroin and other hard drugs and their productivity, education system, and economy have seen no impact.

In Colorado, legalization has seen teen use rates stabilize — not increase — and the data look similar for Washington. Medical marijuana laws are also correlated with reductions in traffic deaths, again, counter to the predictions of naysayers.

But perhaps most importantly, there is growing evidence that marijuana can be used either to replace or significantly reduce the use of opioids for chronic pain. This is the opposite of a “gateway” effect: rather than leading users to harder drugs, it allows them to reduce such use. And because it is impossible to overdose on marijuana, any substitution that occurs here could save lives.

More than half a dozen studies now support the idea that less harmful marijuana can substitute for risky opioids. For example, a study published in JAMA Internal Medicine found a 25 percent lower rate of opioid overdose deaths in states with legal medical marijuana, compared to those without such laws. Another study, published in Health Affairs, found that in states with medical marijuana, each doctor wrote 1,800 fewer annual opioid prescriptions.

A study by the Rand Institute showed that medical marijuana states have not only lower overdose death rates — but also lower opioid addiction rates. And, research conducted with chronic pain patients found that those who used medical marijuana were able to reduce opioid by use by 64 percent — while experiencing fewer side effects and better quality of life. Other research, meanwhile, finds reductions in the number of drivers age 21- 40 involved in fatal crashes with opioids in their system in medical marijuana states.

The implications are clear: enforcing marijuana laws does not prevent or reduce the use of pot or other drugs and may actually drive people from a less harmful habit to a potentially deadly one. To fight overdose, President Trump should allow states that have legalized marijuana to proceed in peace — and should consider changing the status of marijuana under federal law, at the minimum in a way that reduces red tape that discourages research. He should also direct the DEA and other law enforcement agencies to make marijuana the lowest possible priority and use money saved to pay for policies that work, like evidence-based treatment and prevention.